Social attention and the Way to Play Programme

Social attention and the Way
to Play Programme
Neil Stuart,
National Training and Education Director,
Autism NZ
Outline
• Shared attention, referencing and joint attention and their
importance
• The capacities we need to target in early intervention
• The Way to Play programme
Where does it all begin
Jim Sinclair, Don’t mourn for us
• Grieve if you must for your own lost dreams, but don’t mourn for us.
We are here and we’re waiting for you
• The ways we relate are different.
• You’re going to have to learn to back up to levels more basic than
you’ve probably thought about before.
• You’re going to have to give up the certainty that comes from being
on your own familiar territory
• If that prospect excites you, then come join us, in strength and in
determination, in hope and in joy. The adventure of a lifetime is
ahead of you
Nothing new
• Kanners descriptions
• More interested in objects than people Does not look at peoples
faces Rarely responds when called Not interested in other people or
children his age but very interested in objects Regards other people
as an interference Prefers objects to people Not interested in other
people Does not appear to attend to or recognise mothers presence
Lack of social relatedness as “extreme aloneness”
So, we must improve eye contact!!
Too much attention paid to the
quantity and not enough attention
paid to the quality of looking.
Why do people look rather than
the behaviour itself
Uneven repertoire
• Not all non verbal social communication abilities are impacted
• Hardly any difficulty in requesting skills, some difficulties in turn
taking skills but lots of difficulty in joint attention skills
• Imperative vs declarative
Non verbal declarative joint attention skills
• Shared attention
• Referential gazing
• Joint attention
Shared attention
• Emotional regulation
• Understanding of non verbal communication aspects of the face
• Why we look
Share emotion
Celebrate
Anticipation
For information
Referential gazing
Joint attention
• Widely recognised as one of the pivotal skills for sociability,
communication and learning
Early Intervention
• Targeting pivotal capacities for later learning
• “There is evidence that addressing ‘pivotal’ areas will have the
greatest probability of positive effects in many areas of functioning”
• “need to be engaged in developmentally appropriate activities or
interactions for at least 15 to 25 hours per week” NZ ASD Guidelines
Parents
• Diagnosis
• Hiaitus
• ABA vs RDI vs ???
• OUGHTISM “Everyone tells me what I ought to do”
• Pre school pressure cooker
????????
• Pivotal response training
• Incidental teaching
• Early Start Denver model
• Relationship Development Intervention
• Floortime
• SCERTS
• TEACCH
• Not the differences between the programmes it is the similarities
that are important
Similarities
• Clearly defined, developmentally appropriate goals
• Intervention to take place in the natural setting, eg the home, kindy
• Delivered by parents caregivers, empowered and supported by
coaches
• Incorporating the intervention into the daily routines of the cultural
values of the family
Back to the parents
55% of the parents agreed a lot or strongly agreed that their
child played alone most of the time
82% of the parents agreed a lot or strongly agreed that their
child controlled how they played together
95% of the parents agreed, agreed a lot or strongly agreed that
their children had to play the same way each time they played
together
55% of the parents agreed a lot or strongly agreed that their
child was only interested in playing the same games
66% of the parents found it difficult playing with their child
Autism NZ Play Survey
The dark alley
Autism NZ
• Development of a programme that can improve parent’s, caregivers
and support workers confidence to engage with their young child
through play, in order to develop necessary joint attentional
capacities
History
• Gary Davidson, Music Therapist, Julie Timmins, SLT, Neil Stuart,
Educator, Building a relationship with a child with Autism, 2002
Autism Conference
• Oaklynn Special School, Experience Sharing, Julie Timmins, Elena
Antipova, SLT, Debbie May, SLT, Neil Stuart, Educator
• 2 studies
• RASCAL, Julie Timmins, Tanya Catterall, Parent, Jon Manson,
Behaviour Support Specialist, Neil Stuart, Educator
• Using the strengths of children with Autism to support them where
they struggle
Pattern, memory and variation
Overcoming the dark alley
Pattern – a repeating set of actions, done
together
Variations – slight changes though still retaining
the original pattern
A memory catch phrase – to strengthen the
connection and remind in the future
6 simple easy to implement strategies
• Pattern, memory and variation
• Making Yourself Interesting
• Modelling, Interrupting and recreating
• Being the guide
• Using toys as an extension of yourself
• Knowing what’s important
• EVERYDAY SITUATIONS
• One day programme that travelled the country
• Over 300 parents seen from Invercargill to Whangarei
• A great seminar to learn how to play with my son and understand the
approach that fits him best
• I went home straight away and tried the strategies. They worked!!
• Limitations – the W effect
Way to Play at home
• Way to Play at home (Pilot)
• Attendance at way to play 1 day programme
• 6 home visits, 3 group visits
• Coaching the strategy with each visit
• Video feedback
• Significant differences –
My child wants to play with me. I’m not scared any more that the play
is going to stop. He initiates the games we have played together. He
seems more connected
Way to Play online
• Rural and remote - Way to Play online
• Public space and a private space
• Able to upload videos and receive coaching
• 6 lessons online
• Able to connect locally and nationally – own space
Play
• Play’s not just for children!!!
• Got to keep playing
• Questions?
• Many thanks to the parents and their children, Yuki Okamura, artist,